7. Diseases Of The Gallbladder And Bile Ducts Flashcards
Chemical that stimulates gallbladder contraction.
CCK
This chemical mediates the relaxation of the sphincter of Oddi.
CCK
What does relaxation of the sphincter of Oddi allow?
Biliary and pancreatic secretions to enter the duodenum.
Composition of micelles of bile salts.
Cholesterol
Phospholipids
Main component of bile pigments
Bilirubin
Type of gallstone that is mostly calcium bilirubinate (black and brown).
Pigment (associated w/chronic infection or disease states w/ chronic hemolysis)
________secrete bile acids.
Hepatocytes
The 5 F’s: Risk factors for Cholelithisasis
Fat (BMI >30) Female Fertile Forty >40 Fair *Familial
Composition of biliary sludge
Cholesterol crystals
Calcium bilirubinate
Mucin gels
Presence of sludge means: (two things)
1) normal balance deranged
2) Nucleation
Stone and sludge in the gallbladder can cause these 3 main issues: (there are more)
1) Cholelithiasis-stones present, no sx
2) Acute cholecystitis- inflammation
3) Chronic cholecystitis-“great imitator”
This produces increased intraluminal pressure and distension of the gallbladder viscous that CANNOT be relieved by repeated biliary contractions.
Obstruction of the cystic duct OR CBD by stone
A patient presents with SEVERE pain in RUQ that radiates to right shoulder. Consider:
Biliary colic
Big factor that should make you suspicious of acute cholecystitis?
Long duration of pain (>5 hrs)
Precipitating factors for biliary colic:
Fatty meal
Meal after fasting
Any meals
When does biliary colic usually occur?
Nocturnal, w/in a few hrs of retiring